Reconstructive Breast Surgery

Breast Reconstruction

During training Dr Magnusson developed a particular interest in Plastic Surgery of the Breast. This aspect of training was specifically developed during regular training however to further increase qualifications in this field he traveled overseas to work in Scotland and traveled also to Italy to learn from the developers of the current techniques of breast reconstruction. This "Breast Fellowship" led to a vast increase in experience and the opportunity to learn the latest techniques.

Breast procedures:

• Breast reconstruction after mastectomy
• Breast asymmetry reconstruction (different sized breasts)
• Breast reconstruction for congenital deformity
• Breast reshaping after partial mastectomy, trauma or burns
• Breast augmentation/enlargement
• Breast reduction
• Breast lift

30 years ago, women considering breast reconstruction after mastectomy were widely considered to be trying to deny the presence of their breast cancer. Thankfully this antiquated thinking is no longer commonplace. It is known that mastectomy or breast deformity can be associated with very significant disturbance of self image and self esteem. It is also known that breast reconstruction is able to reverse these problems. Furthermore, an immediate (at the time of mastectomy) reconstruction can actually prevent these problems arising. Needless to say, this problem will affect different people to different degrees varying from insignificant for some woman to severe for others. Therefore not every woman will feel that a reconstruction is necessary. Many women will however suffer in silence not aware of the options that exist. Breast reconstruction has had a long history and has reached very high levels of achievement. The results of some techniques may be impossible to distinguish from a normal breast except for the scars from surgery. Even the nipple and areola (dark tissue around the nipple) can be recreated.

Can I consider breast reconstruction:

There are many different types of breast reconstruction and most women are suitable for one or more options. Because of prior surgery, some women will have their options limited. Patients with significant medical problems may also have a reduction in the options available to them. Many patients ask if they are too old for a breast reconstruction. For otherwise fit and well patients, even the more complex types of breast reconstruction can be considered for ladies well beyond their 60th birthday.

Types of breast reconstruction:

Breast reconstruction is a large topic and there are a multitude of choices that may be available to any patient.

The first step in reconstruction is to talk with the patient and determine what the patient's aims and expectations are from breast reconstruction. There are a multitude of options for reconstruction and the specific choice needs to be suited to the individual.

The second step is to create a list of options and compare the list with the patient's desires. The patient's suitability for all options is not guaranteed. For example, prior abdominal surgery may limit the ability to use tummy fat for reconstructions. Options include techniques utilizing tissue expanders and implants, the patients own tissue without implants, and further techniques utilizing a combination of both. Options vary in complexity. In general, the more complex and more lengthy the operation, the more natural the result.

Timing of reconstruction:

The next choice for a patient is timing. Specifically whether to have an immediate reconstruction (at the time of cancer surgery) or as a delayed procedure (at some stage after cancer treatment). There is no point at which it is too late to consider reconstruction after mastectomy and patients will commonly present 10 or more years after mastectomy. Not all patients are suited to an immediate reconstruction. For some patients the tumour will dictate a need to offer only a delayed reconstruction.

Can anything be done for changes following a partial mastectomy:

Increasingly, the management of breast cancer involves a partial mastectomy and radiation instead of a mastectomy. For many patients this is a subtle change to the breast however for some this will result in a breast deformity. It is not widely appreciated that the breast can be reshaped at the time of partial mastectomy and gives an improved cosmetic result. As an example, a large breasted woman can have a modified breast reduction to remove the tumour, and a normal breast reduction can be performed simultaneously on the opposite side to retain symmetry and achieve an optimal cosmetic result. These results are not as easily achieved after radiation, as a delayed procedure.

The timing of reconstruction:

Breast reconstruction forms a very significant part of Dr Magnusson's practice. Both immediate and delayed surgery for reconstruction is available to patients in private hospitals in Toowoomba. An immediate reconstruction is not available if it is not considered.

Resources:

You can contact the Queensland Cancer Fund who provide an important support service for ladies with breast cancer and can also give you information regarding breast reconstruction. In many instances they will also be able to introduce you to ladies who have had this procedure. The Toowoomba Branch of the Queensland Cancer fund can be contacted on phone number:

Ask for Alex woodland on: 07 4638 4799
Or use their e-mail address: qcfswq@qldcancer.com.au
Or the web site: www.qldcancer.com.au